The concept of telemedicine is catching on quickly, as healthcare professionals realize the positive results and powerful implications of reaching underserved populations, seeing more patients, and improving healthcare. Could dentistry follow suit? Would you want it to?
Benefits of Teledentistry
Just like medical practitioners, dentists could use live video, remote patient monitoring and patient self-reporting, and remote access to patient records (store-and-forward consultations) to deliver dental care. This could be especially useful in reaching rural communities, low-income populations, and senior citizens. Lack of time, difficulty traveling, and difficulty finding a dentist are some of the top areas that adults cite as reasons for not visiting the dentist. Teledentistry could address each of these issues simultaneously.
The perceived lack of value in visiting the dentist is another reason many adults do not regularly schedule checkups. What if, by offering dental care remotely, dentists could close the value gap if being “seen” by the dentist becomes easier and more convenient? Offering a new form of technology would help dentists position themselves to current and potential patients as being innovative, which could help increase the value proposition keeping some adults away from the dental chair now.
Other tangible benefits to patients and dentists alike include decreased wait times, more efficient patient scheduling, no travel costs for patients, and lower reported anxiety in case studies.
In addition to increased access to dental care, dental schools could also benefit from teledentistry as an educational tool.
Practical Uses of Teledentistry
Teledentistry has many relevant and practical applications. Live video feeds, when equipped with the proper technology like intraoral cameras, can permit a dentist to review and supervise routine oral hygiene care and follow-up appointments. For routine, preventive dental care, on-site services can be performed by a licensed hygienist and supervised by a dentist participating in live video feed.
Dentists can diagnose problems and begin a patient care plan without ever needing to be on-site. In cases where a patient is required to see a specialist or travel long distances, this option is especially useful. Live video feeds are most useful for low-risk patients who need basic oral maintenance and follow-up or preventive care.
Remote patient monitoring, or RPM, allows patients and dentists to facilitate dental care on their own time. Patients report feeling more at ease asking questions and completed follow-up care more often. In fact, case studies have reported that patients with chronic diseases have better outcomes when they used RPM to complement their existing dental health treatment plan. When patients can email their dentists through a secure network, the dentist can respond at convenient times and develop treatment plans away from the hustle of a busy office.
With store-and-forward consultations, dentists and specialists can securely send patient records, x-rays, and images to better collaborate on a comprehensive treatment plan. This works especially well for rural patients who needed to travel long distances to see a specialist. Store-and-forward permits the specialist to confer with the on-site general practitioner to continue the treatment plan without any added inconvenience to the patient – or the need to schedule additional appointments in the office for the specialist.
Many states already mandate that teledentistry services be reimbursed by insurance companies and Medicaid, eliminating the dentist’s risk of taking on this new service. There is no federal mandate, however, so there a wide range of covered and non-covered services across states.
Maryland, for example, currently reimburses Medicaid patients for live video monitoring, but not the exchange of files such as x-rays or remote patient monitoring. Proposed changes to legislation are in the works but the outcome is unclear. Maryland also has a version of a collaborative hygienist practice wherein a dental hygienist is located on-site at certain long-term care facilities and collaborates with an off-site dentist for treatment plans.
Challenges to teledentistry vary but the common issue is how dentists will get paid and if insurance companies cover services, followed by ensuring HIPAA compliance. The unclear regulatory landscape can make teledentistry difficult to implement, and the dentist’s liability remains somewhat unclear. Otherwise, it can be costly to purchase the equipment needed and it will take time to train staff. Despite these setbacks, the long-term benefits are many.
At a time when more than 30 percent of Americans are without dental insurance and many more forgo regular visits to the dentist, access to oral health can improve patients’ overall health and well-being. Teledentistry can do a great deal to bridge that gap.
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